Answer by Dr. Bret Wickstrom:
The only way to resolve this secondary problem (symptom) is to determine the primary condition that is causing it. There are a few, but not all, of the issues that are common for this type of intermittent pain.
1. The most common is a shift in the structure of your spine. Just like with your blood pressure, body temp etc. there is a standard for is considered “normal”. When your spine shifts away from that normal it puts excessive pressure on the bones, discs and nerves in the spine the same way that an uneven foundation of a house puts uneven stress on the walls, doors, and windows and can lead to secondary issues in the house like cracks in the wall squeaky doors and window that don’t open easily. You can choose to either treat the windows, doors, and walls directly or you can treat the foundation ( the primary cause of the problem.
The only way to determine if this is the primary cause of your problem is to have a chiropractor do structural radiographs and compare them to normal. It is very likely that a shift in your spine is putting more stress on the muscle, discs, or nerves in that area when standing and not sitting. Sometimes it happens the other way (sitting vs standing). It depends on the shift.
2. Acute injury to the postural muscles. It is possible you could have injured the core muscles that are used more during standing and are not as active while sitting. Thus you are not activating them and they then do not hurt while you’re sitting.
3.a. Chronic injury to postural muscles. More often than number 2 is that number 1 caused constant stress to the muscle but not symptoms were present until much later when the proverbial straw broke the camel’s back and you were finally able to feel the problem. Don’t forget that pain is often the last thing to show up to highlight a primary condition. E.g. pain in your arm from a heart attack does not show up the second you start developing heart disease. This is the main reason chiropractors and many other holistic doctors are so adamant about preventative care and addressing lifestyle before you have secondary symptoms show up.
3.b. Sequelae to 3.a. is often trigger points which can cause poor muscle function by shortening the length of and limited the motion of muscles. Trigger points are often overlooked and can even cause referral type pain similar to sciatica and other nerve pain.
3.c. Postural muscle imbalance which is also often a sequela to number 1 but can also be caused by repetitive one-sided or unbalanced motions or postures. I.e. working on an assembly line, constantly turning your torso to one side or always standing with your hip shift to one leg (possibly from an anatomically short leg).
Walking can reduce the pain in these situations because it requires other, potentially injury/uninvolved muscles for that motion that will help to stabilize the spine while walking but are not activated while standing or sitting.
These are just a FEW possibilities. This is why it is imperative that you have a neuromusculoskeletal expert (chiropractor) do a structurally focus exam to determine the PRIMARY condition that is causing the problem. Knowing the cause is the only way to determine the course of treatment to resolve it.
Finally, THIS IS NOT AN AGE-SPECIFIC CONDITION! Do not let anyone convince you that back pain is only due to aging. If someone tells you this, even if they’re are a doctor, I encourage you to immediately find a second opinion. It is true these things are more COMMON in older people because they have had more time for these imbalances to progress but I see them it very young kids all the time.
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